There has been a lot in the media recently about electronic smoking devices such as e-cigarettes, hookah pens and vape pens. If you haven't seen them in your neighborhood store, you may have seen someone using them, or "vaping."

Electronic smoking devices are battery-operated products designed to deliver nicotine, flavor and other chemicals. They often resemble the look of a cigarette, including a battery-lit glow at the end of the device. They turn nicotine, which is highly addictive, and other chemicals into a vapor that is inhaled by the user.

They also come in youth-friendly, high-tech designs and flavors like cherry crush, grape, vivid vanilla, cinnamon bun and mint chocolate.

While the advertising for these products may say they are a safe alternative to tobacco cigarettes, there is much more research that needs to be conducted to make this claim.

Electronic smoking devices are unregulated by the federal government at this time, and the Food and Drug Administration (FDA) warns that consumers currently have no way of knowing whether e-cigarettes are safe for their intended use, what types or concentrations of potentially harmful chemicals are found in these products, or how much nicotine they are inhaling when they use these products.

In short, e-cigarette users don't really know what they're putting in their bodies.

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In addition, we don't know how the vapor from electronic smoking devices affects people in the vicinity of where they are being used. The FDA has conducted laboratory analysis of electronic cigarette samples and found they contained carcinogens and toxic chemicals to which users and bystanders could potentially be exposed.

A major review by UCSF researchers of the scientific literature on these devices found that the while the data is still limited, these products are not "merely harmless water vapor" as the manufacturers frequently claim. The researchers concluded that these devices should be prohibited wherever tobacco use is prohibited.

Just as important as the possible health risks associated with these products, there is growing concern that the use of e-cigarettes in public and places of employment could increase social acceptance of smoking, undermine smoke-free ordinances, and make smoking seem socially normal, especially among youth.

There is also a concern about triggering relapse in those who are trying to quit smoking. Because these products look incredibly similar to tobacco cigarettes, and simulate smoking, they may provide models for unhealthy behavior.

In a study published in the March 6 Journal of the American Medical Association's JAMA Pediatrics, it was found that e-cigarettes were associated with more -- not less -- cigarette smoking among adolescents. In fact, electronic smoking devices are likely to be "gateway" devices for nicotine addiction among youth, according to the study.

In April of last year, the Contra Costa Board of Supervisors voted to include electronic smoking devices such as e-cigarettes in the county's Secondhand Smoke Protections Ordinance, prohibiting the use of electronic cigarettes wherever smoking is prohibited, including in common indoor and outdoor areas of multiunit housing.

Richmond, Walnut Creek, Concord, Oakley and Pittsburg have also joined the 60 other jurisdictions in California that prohibit the use of electronic smoking devices where smoking is prohibited.

For those trying to stop smoking, the Centers for Disease Control has found that FDA-approved cessation aids like nicotine patches or gum may help smokers quit. For information on smoking cessation resources, call 800-NO-BUTTS or visit cchealth.org/tobacco.

Denice Dennis, MPH, is the Tobacco Prevention project manager for Contra Costa Health Services. Healthy Outlook is written by the professional staff of the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.